폐암 환자에서 Cyfra 21-1의 진단적 유용성 평가
Diagnostic Utility of Serum Cytokeratin Fragment 21-1 in Patients with Lung Cancer
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배경: 폐암은 전 세계적으로 가장 치명적인 암 중의 하나이다. 혈청 사이토케라틴분절 21-1 (Cytokeratin fragment 21-1, Cyfra 21-1) 측정은 폐암의 진단에서 좋은 민감도와 특이도를 지닌 종양 표지자로 알려져 있다. 본 연구에서 폐암의 선별 검사로 Cyfra 21-1의 유용성을 평가하고자 한다. 방법: 연구 대상은 건양대학교 병원을 방문한 폐암 환자 169명, 양성 폐질환자 124명, 정상 건강검진자 521명으로 총 814명을 후향적으로 분석하였다. 혈청 Cyfra 21-1은 Architect CYFRA 21-1 kit를 이용하여 Architect i2000 분석기에서 측정하였다. 결과: 폐암 환자에서 Cyfra 21-1의 중앙값 및 사분범위(비소세포성 폐암: 3.16 [1.98, 9.00] ng/mL, 소세포성 폐암: 3.32 [2.07, 5.20] ng/mL)는 양성 폐질환자(1.50 [1.17, 2.17] ng/mL) 및 정상 군(1.26 [0.93, 1.75] ng/mL)보다 통계적으로 유의하게 높았다(각각 P<0.01). Cyfra 21-1의 민감도, 특이도, 양성 예측치, 음성 예측치는 각각 70.4%, 81.2%, 49.6%, 91.3%였다. 또한 Cyfra 21-1의 곡선하면적은 0.839 (95% confidence interval 0.802-0.877)였다. 결론: 본 연구 결과 Cyfra 21-1은 폐암을 진단하는 데 유용한 종양 표지자임을 확인할 수 있었다.
Abstract
Background: Lung cancer is the most lethal malignant neoplasm in the world. Serum cytokeratin fragment 21-1 (Cyfra 21-1) is a valuable tumor marker for detection of lung cancer, and it has good sensitivity and specificity. The aim of this study was to investigate the diagnostic value of Cyfra 21-1 levels in patients with lung cancer. Methods: We retrospectively reviewed 814 samples from 169 patients with lung cancer, 124 patients with benign pulmonary diseases, and 521 normal controls from health check-up clinic. Serum Cyfra 21-1 levels were determined with Architect CYFRA 21-1 kit (Abbott, USA) using Architect i2000 analyzer. Results: Median levels and interquartile ranges for Cyfra 21-1 in patients with lung cancer (non-small cell lung cancer: 3.16 [1.98, 9.00] ng/mL, small cell lung cancer: 3.32 [2.07, 5.20] ng/mL) were higher than those in patients with benign pulmonary diseases (1.50 [1.17, 2.17] ng/mL; P< 0.01) and in normal controls (1.26 [0.93, 1.75] ng/mL; P<0.01). Sensitivity, specificity, positive predictive value, and negative predictive value for Cyfra 21-1 were 70.4%, 81.2%, 49.6%, and 91.3%, respectively. The area under the curve for Cyfra 21-1 was 0.839 (95% confidence interval, 0.802-0.877). Conclusions: We concluded that Cyfra 21-1 may be useful in the diagnosis of lung cancer.
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